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      Physiological Response to Superantigen-Adsorbing Hemoperfusion in Toxin-Concentration-Controlled Septic Swine

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          Background/Aims: Superantigens are suspected of being potent initiators of gram-positive sepsis, and new therapies for superantigen elimination are required. The effects of hemoadsorption with a superantigen-adsorbing device (SAAD) were evaluated in septic swine. Methods: Toxic shock syndrome toxin-1 (TSST-1) was infused, and blood concentration was maintained at the clinical level for 6 h. Endotoxin was then infused to induce lethal shock. All animals were hemoperfused with SAAD or a control column for 8 h and changes in pathological parameters and mortality were examined. Results: Animals perfused with SAAD had a highly significant (p < 0.01) survival advantage compared with control groups at 24 h after initiation of the TSST-1 infusion. SAAD also suppressed the increase in the arteriovenous shunt ratio and decrease of partial arterial oxygen pressure at 6 h after TSST-1 infusion initiation. Conclusion: We suggest that there is a potential application of SAAD in treating superantigen-induced respiratory dysfunction and sepsis.

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          Most cited references 11

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          Bacterial superantigens.

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            Report of the American-European consensus conference on ARDS: Definitions, mechanisms, relevant outcomes and clinical trial coordination

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              Superantigens: microbial agents that corrupt immunity.

              Microbial superantigens are a family of protein exotoxins that share the ability to trigger excessive and aberrant activation of T cells. The best characterised are the staphylococcal enterotoxins and the streptococcal pyrogenic exotoxins that trigger the staphylococcal and streptococcal toxic shock syndromes. It is now apparent that superantigens have a wider role in the pathology of infectious diseases than has previously been appreciated. Staphylococcus aureus and Streptococcus pyogenes together produce 19 different superantigens. The range of microorganisms known to produce superantigens has expanded to include Gram negative bacteria, mycoplasma, and viruses. Research is beginning to shed light on the more subtle parts these molecules play in causing disease and to produce some real possibilities for specific treatment of superantigen-induced toxicity. We aim to highlight these new developments and review the science behind these fascinating molecules.

                Author and article information

                Blood Purif
                Blood Purification
                S. Karger AG
                April 2006
                27 April 2006
                : 24
                : 3
                : 319-326
                aNew Frontiers Research Laboratories, Toray Industries, Inc., Kanagawa; bSpecialty Material Research Laboratories, Toray Industries Inc., Shiga; cFifth Department of Surgery, Hachioji Medical Center, Tokyo Medical University, and dDivision of Critical Care and Emergency Medicine, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
                91851 Blood Purif 2006;24:319–326
                © 2006 S. Karger AG, Basel

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                Page count
                Figures: 4, Tables: 1, References: 19, Pages: 8
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